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New perspectives on lung cancer screening, cystic fibrosis, and other key topics in pulmonary medicine are presented in the special January issue of The American Journal of Medical Sciences.

New perspectives on lung cancer screening, complications of sleep apnea, cystic fibrosis, and other key topics in pulmonary and critical care medicine are presented in the special January issue of The American Journal of Medical Sciences, published by the Southern Society for Clinical Investigation and Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, provider of leading healthcare content, context and consulting.

The special issue features highlights of the 17th Annual Charleston Pulmonary and Critical Care Symposium, hosted by the Division of Pulmonary, Critical Care, Allergy and Sleep Medicine at the Medical University of South Carolina. "It was our intent to provide new, clinically useful information relating to common pulmonary disorders that can be applied to your patients," writes Dr. Steven A. Sahn, M.D., Director of the Division.

The thirteen papers in the special issue provide practical updates on conditions such as chronic obstructive pulmonary disease, a common and costly condition most often related to smoking; and sarcoidosis, an inflammatory lung disease that can range from life-threatening to asymptomatic. Several articles emphasize the need for expert evaluation for prompt diagnosis and appropriate treatment of complex conditions such as organizing pneumonia, pulmonary arterial hypertension, and 'unexpandable lung.'

Other topics of interest in the special Pulmonary Symposium issue include:

• Lung cancer screening. Some studies have suggested that performing chest CT scans, particularly in smokers, could help detect lung cancers earlier. So far, however, there is no evidence that CT screening improves overall survival for lung cancer patients. Future studies will determine the ultimate value of CT screening-meanwhile, programs to discourage smoking and help smokers quit are likely to have a greater impact on lung cancer deaths.
  
  
• Diagnosis and complications of cystic fibrosis (CF). With genetic screening programs, CF is being diagnosed earlier-even before birth-allowing earlier initiation of treatment. As more CF patients survive into adulthood, new patterns of pulmonary problems are starting to emerge. Monitoring, recognizing, and treating these complications is an essential part of long-term care for adults with CF.
  
  
• Metabolic complications of obstructive sleep apnea. Recent studies suggest that nightly episodes of oxygen deprivation lead to a 'proinflammatory' state, which may explain some of the serious complications of this condition. There is also evidence that, without treatment, obstructive sleep apnea can interfere with appetite regulation, thus leading to increased weight gain-and worsening sleep apnea.
  
  
• Critical care for pregnant patients. There are few research data to guide care in this difficult situation. In general, unless a drug is known to be toxic to the fetus, the risks of not giving needed treatments to the mother probably outweigh the risks to the developing fetus.
  
  
• Air travel for patients with lung disease. Because of the risk of complications related to cabin pressures, a careful preflight examination is recommended for patients with serious lung diseases. Some patients may be cleared to fly if they receive supplemental oxygen. Those with certain severe or unstable pulmonary conditions should not fly.
  
  
• Pleural fluid analysis. Dr. Sahn presents two papers on pleural fluid analysis, a key test for use in diagnosing the cause of pleural effusion-an accumulation of fluid within the pleural space. As part of a comprehensive evaluation, pleural fluid analysis can diagnose the cause of the problem in up to 95 per cent of patients.

Dr. Sahn serves as Director of the Charleston Symposium, a premier educational event for pulmonologists, critical care physicians, internists, and thoracic surgeons. The 18th Charleston Pulmonary and Critical Care Symposium is planned for March 14 to 16, 2008. "We encourage all interested physicians to consider joining us for this practical clinical update, emphasizing a pathophysiologic basis for a rational approach to therapy," says Dr. Sahn. For more information, visit the MUSC office of Continuing Medical Education at http://cme.musc.edu/.


Source: Lippincott Williams & Wilkins